Doctor Name: | DR. THOMAS GARLAND MAGRUDER |
NPI Number: | 1063773810 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 1924 Alcoa Hwy # U109 Knoxville, TN - 379201511 |
Business Phone Number: | 8653059220 |
Business Fax Number: | |
Mailing Address: | 135 W Ravine Rd, Ste 5-b KINGSPORT |
State: | TN |
Postal Code: | 376603847 |
Phone Number: | 4232243460 |
Fax Number: | 4232243465 |
NPI Enumeration Date: | 06/07/2012 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |